Unlike melanoma, Merkel cell carcinoma, another potentially deadly skin cancer, has no definitive physical characteristics. A man in his 60s presented to our clinic with a 4-month history of a rapidly enlarging, raised nodule on his head. It was associated with intermittent tenderness due to its size and location but did not cause significant pain. At his initial presentation, the patient denied having fever, chills, unintentional weight loss, and other systemic symptoms. His past medical history was noteworthy for actinic keratoses and multiple basal cell carcinomas.